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Comment by ApolloFortyNine | Hacker News Reader

>The global health body said a systematic review of the available evidence had suggested that use of non-sugar sweeteners, or NSS, “does not confer any long-term benefit in reducing body fat in adults or children.”

As someone who used artificial sugars exclusively as part of a low carb diet to lose 40 pounds, this just seems like an insane statement to make no?

Unless the WHO no longer believes calories consumed matters at all, replacing sugar with a 0 calorie substitute literally leads to less calories. Obviously if someone just eats more to compensate there's no net gain, but that's pretty much the same as someone who eats 20 apples a day just because they heard they're healthy. That obviously wouldn't mean apples are bad for you.

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> Obviously if someone just eats more to compensate there's no net gain

I remember a study that showed people who consumed NSS would end-up on their own accord, eating additionally the same amount of calories as they were "avoiding" in their beverages. Ie. 2 cans of soda roughly 350cal, 2 cans diet soda -> eat another 350cal that day without actually planning on it. I think the hypothesized reason is that many of these 0-cal sweeteners still cause a release of insulin which then drops your blood sugar, which then makes you crave carbs more. I personally try to consume sweetners with no insulin effect for this reason (eg. Stevia) whenever I do use one.

FWIW I have a similar gut reaction to this headline. How can there be completely no benefit to not adding 30-60g of sugar to my bloodstream every day? If the sweetners are combined with a controlled diet, I would still think they have benefits. I don't feel my blood pressure rise or my mood shift when I have a little NSS, which is the opposite of consuming straight sugar for me, I can feel it.

> people who consumed NSS would end-up on their own accord, eating additionally

(Note: this comment is not disagreeing with the parent)

In my opinion, studies like these (and especially the pop "science" articles that package them into clickbait) are flawed because:

1. They summarize and basically take a mean across an entire population (see quote above for an example), which means a wide spectrum of behavior patterns are being reduced to "people do xxxxx" which is obviously not universally true. Some people will do something, and others won't. This study assumes you're not in control enough or smart enough to NOT do that unproductive behavior when trying to lose weight. I know it's a cliché that everyone assumes they're smarter than normal people, but, surely some are, right?

2. The "People will just xxxxxx" line -- that basically crosses right into psychology, which... some people would say is the least objective 'science.'

I mean, people can go right ahead and convince themselves that switching to literal sugar will be a positive effect on the body. I'll just keep drinking diet soda, which has also eliminated tooth decay as a serious concern in my life since I switched.

You already hit on it. Insulin is the fat storage hormone. It triggers your fat cells to expand by absorbing sugars from the blood. But NNSs aren't absorbed by fat cells, so they stay in your blood longer, keeping your liver working longer, pumping out insulin. This results in diminishing insulin response over time.

I’ve heard this theory before, but have never seen any actual science done. If you have a pointer to any, I would love to see it!

Here's one that tested sugar+sweetener, note the decrease in insulin clearance when sweeteners are consumed, vs just sugar:

sucralose ingestion caused 1) a greater incremental increase in peak plasma glucose concentrations (4.2 ± 0.2 vs. 4.8 ± 0.3 mmol/L; P = 0.03), 2) a 20 ± 8% greater incremental increase in insulin area under the curve (AUC) (P < 0.03), 3) a 22 ± 7% greater peak insulin secretion rate (P < 0.02), 4) a 7 ± 4% decrease in insulin clearance (P = 0.04), and 5) a 23 ± 20% decrease in SI (P = 0.01).

https://diabetesjournals.org/care/article/36/9/2530/37872/Su...

Thank you!

The report mentions one of the effects of NSS is lower caloric intake.

What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much.

Especially if there are other side effects of consuming "sweetener" like wanting to eat a tiny bit more (the opposite of using mouthwash, for example, which makes you want to eat nothing more).

> What people may not realize is your body is quite "efficient" at running at various caloric amounts, and ±569 kJ/day (135 calories) may not do much.

Source? I'm very much in the camp that diet has a huge impact on one's ability to control their eating, but I've never seen anything that suggests that calories in calories out doesn't apply (outside of extremes, like genuine starvation).

Calories in = calories out, but 135 calories is not much (that's what, a 30 minute slow walk for an average American)?

So if you drop your intake by 135 calories you may just not walk as much and not even really notice it. Or your body may slow down metabolism a tiny bit, etc.

Yeah but then again the average american walks ~3000 step a day, which is about 30min.

To add on to what bombcar said: I don't think the implication is CICO doesn't apply.

In my experience (and also studies) change in calorie intake is correlated with change in activity i.e.: when you eat more you naturally move more. Not just exercising and walking but also jittering and cleaning that little bit harder and moving that little bit faster. Or the opposite, saving a little bit of energy.

Instead of moving your whole head to look at something - just a glance and so on.

CICO is still valid but the body adjusts beyond what we can _easily_ measure. It's a lot more complicated but the above is one simple example how it adjusts.

Exactly. You have to combine a caloric drop with an intentional increase in activity and even then it can take awhile for the changes to start to add up to be noticeable.

Calories in calories out always applies. But calories out is a moving target and is influenced by calories in.

So you are saying dieting does not work? Reducing calories is not the path to weight loss?

I am saying that the data in the report measures such a small amount (apparently) that it is hard to draw useful conclusions.

I.e., as with many metareports, it's kinda worthless, it seems.

Calories not important. Type of calories important. Fibre contains calories, but they are locked up in a hard chemical shell that your body cannot crack, and therefore is unaffected by it. So, 200 calories of regular carbs are far more fattening than 200 calories of fibre carbs.

Edit: When I said that the body is unaffected by it, I was referring to the fact that fibre does no trigger the same cascading chemical reaction that other carbs do. No amount of fibre will cause an insulin spike and increased fat storage.

The types of foods (and NNSs) we consume, and the chemical affects they have, are more important than the amount we consume.

The reduced availability of food energy from fibre is already accounted for in at least Canada's food labeling rules: https://inspection.canada.ca/food-labels/labelling/industry/...

Energy value of dietary fibre

A value of 2 Cal (8 kJ) per gram should be used for the dietary fibre portion of the fibre source.

A value of less than 2 Cal (8 kJ) per gram may be used for the dietary fibre content if a specific value is available for the fibre source.

Energy value of bran

The energy value of the fibre portion of wheat bran is 0.6 Cal (2.5 kJ) / g and the wheat bran itself has an energy value of 2.4 Cal (10 kJ) / g.

Yes, but it is not only the difference in available energy that is important. Fibre, although it is a sugar, does not trigger the same insulin response that other sugars (and NNSs) do.

This is largely incorrect, and also not what the person you're replying too is saying. Calorie numbers in food are just a weighted sum of the grams of carbs, fats, and proteins in the food. Each of those groups are assigned a fixed weight based on an estimate of how many usable calories are in a gram of each.

The commenter above is talking about how we often ignore the adaptability of the body, and that if you suddenly cut caloric intake by say 300 a day, the body will surprisingly quickly adapt by lowering metabolic rate to compensate. This can be done through the simple modulation of hormones and may also involve the shedding of metabolically expensive tissue, like muscle.

I thought nutrition labels already didn't count the calories in fiber that you can't absorb.

It's complicated. Reducing calorie intake is absolutely a path to weight loss, but we tend to ignore the adaptability of the body. If you suddenly reduce your caloric intake, the body thinks it's entering into a time of scarcity and will lower its metabolic rate through hormone modulation and by shedding muscle.

This is one reason why people struggle so much with dieting. They lose lot's of weight at first, but then plateau when the body adapts. When they get discouraged and fall off the diet, they put the weight back on quickly because they now are burning less calories than when they started.

The most effective way of losing weight long term is likely some combination of a slight caloric deficit paired with resistance training (to discourage the body from shedding metabolically expensive tissue) and short bouts of reverse dieting . (ie. slight deficit for 3 weeks, then 1 week of a slight surplus, etc.)

> the opposite of using mouthwash, for example, which makes you want to eat nothing more

.. sorry to be stupid for a second. Is this due to the taste? Or is there a known side effect of some types of mouthwash that inhibit hunger?

I've never noticed anything, hence the question. I'd eat right after with no issue basically, but i don't because it's bad for your teeth to my understanding.

I don't know if it happens to everyone, or if it is just suggestion from normally being done before bed, etc, but the "post mouthwash mouth" makes me not want to eat again, maybe just because I'd have to brush/wash again.

Or it could be that it "cleans" the palate so you're not "tasting" any sugars/food anymore so you go out of "it is eat time" mode.

I am the opposite. For some reason, I want to eat immediately after using mouthwash, but maybe that is because I always want what I cannot have.

People who drink sodas drink way more than 135kcal per day of sugary ones. One can is more than that

The report is "technically correct" and also completely idiotic from a "putting the diet into practice" perspective.

It seems like the average consumer of diet sweeteners is already likely to be overweight, diabetic, or have other ailments. This article seems highly sensationalized. For the average person, the risk of sugar impacting blood glucose levels seems far riskier than any side effect of a NSS

As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke."

I suppose we could do a nation-wide experiment by insisting that the sugar water vendors use only NSS for a year; but that would probably result in the overthrow of the government.

> As a former twitter entertainer once said, "I have never seen a thin person drinking Diet Coke."

There's a lot he hasn't seen in this world. Doesn't mean those things don't happen.

Yeah, and also not even an insightful joke. I mean, isn't Taylor Swift, notable thin pretty human, a famous Diet Coke fan? That's just the first person who comes to mind. Also half the people I know, as well.

That tweet doesn't reflect my experience at all actually, in Europe at least. I know it's an anecdote but I know many fit people that drink frequently Diet Coke or Coke Zero. Is this a US thing?

Coke Zero is much more common as an Everyman drink in Europe apparently, perhaps because of less sugar insensitivity.

In the USA a large size combo meal with a diet coke coming in at 1500+ calories is a meme based in reality.

The fattest person I ever worked with used to drink 4-8 litres of diet coke a day. When I met him again two years later, his weight was normal. Asked how he did it, he just stopped drinking the diet coke.

NNSs trigger the same insulin/fat storage mechanism as sugar, but they arent absorbed, and stay on the blood longer, leading to insulin resistance.

Please point us to some science about this, because of that is true, it’s a pretty big deal.

It's anecdata but I've seen similar - however, it could also be explained by "not taking weight loss seriously if all you do is switch to gallons of diet drink".

And for lots of sodas, caffeine plays, too. It's hard to factor out the various issues that could also be present.

There's lots. Here's one that tested sugar+sweetener, note the decrease in insulin clearance when sweeteners are consumed, vs just sugar:

https://diabetesjournals.org/care/article/36/9/2530/37872/Su...

Also interested to see if there's any proof of this. I know, anecdotally as an obese man, that whether I cut out diet soda or not doesn't seem to make a difference. Maybe I'm not doing it for long enough?

Are you drinking 4-8 litres a day?

Nowhere near that much.

Good. The dose makes the poison.

"Obviously if someone just eats more to compensate there's no net gain"

Words like "obviously" and "just" are papering over a complicated system called metabolism. Nothing is really "just obvious" in human body, which is a result of a billion years of chaotic evolution.

If artificial sugars mess with an average person's feelings of satiety or kill useful gut microbiome, you can't expect them to help an average person to lose weight.

Things like hunger cravings matter for most people when it comes to weight regulation. You might be one of the few exceptions.

Yes. To add, cravings regulated by hormones.. also related to set point.. also related to ozempic

Caloric scale was invented in the 19th century to measure the energy of fuels in a furnace.

Human body is not a furnace. Human body is a complex chain of cascading chemical reactions. When you eat sugar, an instruction is sent to the liver to produce Insulin in the blood. Insulin is the fat storage hormone, it signals to fat cells that they should absorb sugars from the blood stream.

Mountains of research show that, just as sweeteners trigger a sugar-like chemical reaction in your mouth, they also trigger that same reaction in your liver.

Attia's book 'Longevity' had a great point on this. Studies have found that artificial sweetener wasn't associated with weight loss, higher a1c, etc. What they don't tell you is those people most likely to use a lot of artificial sweeteners are probably overweight and prediabetic, and have over-eating issues beyond just what they're using to sweeten their drinks.

> As someone who used artificial sugars exclusively as part of a low carb diet to lose 40 pounds, this just seems like an insane statement to make no?

i don't mean to sound too negative but i'm no longer impressed by "dropped X pounds" statements having done that and more several times. The only success criteria that impresses me now is keeping it off for 5+ years. If the WHO says "systematic review of the available evidence" against "long-term use of sugar substitutes" it's probably worth paying attention to. Since you haven't even specified your timeline, we have no idea if it qualifies as long-term use or not.

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